The Use of Convalescent Plasma Therapy on COVID-19 Filipino Patients: A Tertiary Center Experience

Aim: To know the effect of Convalescent plasma in clinical and laboratory parameters of the recipients, the effect of convalescent plasma in clinical and laboratory parameters of the CPT arm and control arm, to identify the association of early consultation to severity and outcome, early administration of convalescent plasma to severity and outcome and lastly to identify overall effect of convalescent plasma to overall mortality and overallmortality with severity.

Methods: Prospective, non-randomized, Cohort Study.

Results: 35 patients were assigned as plasma recipients and 35 patient as control arm receiving standard of treatment alone. They were matched based on age, sex, severity. Descriptive statistics shows comparability of both arms. There is noted positive effect of convalescent plasma in the temperature(Mean Pre-CPT Temperature of 37.05±0.61, Mean Post-CPT Temp of 36.54±0.50, p-value of 0.001), and Systolic Blood pressure (Mean Pre-CPT SBP 126.62±17.41, Mean Post-CPT SBP 119.32±14.66, p-value of 0.033). Among the clinical parameters, CBC, significant difference was noted in the eosinophils and MCHC, CRP among the inflammatory markers, SGOT for the liver function test, in the arterial blood gas parameters there was noted significant difference in the level of paO2, pCO2, HCO3 in favor of a positive effect of convalescent plasma except for the eosinophils which may be negative in nature. Among the clinical parameters, there is noted significant difference in favor of CPT in the values of Oxygen saturation, white blood cell, neutrophil count, lymphocytes count, basophils, eosinophil count; there was significantly lower values for inflammatory markers in the CPT arm namely in LDH, CRP, DDMER, Procalcitonin; the same was noted in the liver function test(SGPT, SGOT), arterial blood gas, specifically, in paO2 and Chest-Xray lesion. There is significant difference favoring the control arm in the Rox index, O2 support. There is significant difference favoring those who were discharged in both mean systolic and diastolic pressure, in the hematocrit, white blood cell count, monocytes, Basophils, MCV, MCH, MCHC. All inflammatory markers favors the CPT arm. Same positive effect was seen in the pH and pCO2 and Chest-X Ray lesion. Results showed that there is weak positive correlation between duration of symptoms to consult and disease severity with Spearman's correlation coefficient of 0.1591 but not significant. No sufficient statistical evidence to conclude that duration of symptoms to consult is associated with mortality. Furthermore, in looking at the association of giving CPT early in the disease presentation and severity as well as outcome, results showed that there is weak negative correlation between duration of symptoms to CPT and disease severity. But, not significant. Duration of symptoms to CPT was found to be significantly associated with mortality. There is no sufficient evidence to conclude that CPT is associated with a favorable outcome among COVID-19 patients. Same results were observed after doing sub-analysis according to severity of disease.

Conclusion: Convalescent plasma, in general, did not show improvement in clinical and laboratory parameters among recipients. But, CPT recipients show better clinical and laboratory parameters compared to the control arm(non-CPT recipient). Early administration of convalescent plasma may decrease mortality. There are no significant differences observed in over-all cause mortality among CPT recipients and those recipients of the best available treatment alone.

No relevant conflicts of interest to declare.